Nalbuphine and
tramadol are potent
analgesic drugs. Our aim was to preliminarily assess and compare the efficacy and safety of
nalbuphine and
tramadol for postoperative
analgesia in children. In a double-blind design, 24 ASA 1-3 children aged 1 to 10 years undergoing a scheduled
surgical procedure were randomly allocated to receive either an intravenous bolus dose of
nalbuphine 100 microg/kg immediately before the end of surgery followed by an infusion of 0.2 microg/kg/min for 72 hrs., or an intravenous bolus dose of
tramadol 1000 microg/kg followed by an infusion of 2.0 microg/kg/min for 72 hrs.
Postoperative pain control and
drug-related adverse events were recorded. Three children who received
nalbuphine required an extra bolus dose within the 12 hrs. of post-surgery versus one child in the
tramadol group. A similar number of patients in both groups required an increment in the infusion rate within the 72 post-surgery hours. Sedation was observed in 2 children in the
nalbuphine group and in 1 child in the
tramadol group. Four children presented
vomiting with
tramadol and two with
nalbuphine. Cardiovascular parameters remained within the normal ranges in both groups. In conclusion, the bolus/infusion regimen of
tramadol evaluated in this study appears to have better postoperative
analgesic efficacy than the bolus/infusion regimen of
nalbuphine. These preliminary results require further confirmation by studies with a sample size enough to clearly identify differences in their efficacy as well as in the rate of adverse events secondary to the administration of each of them.